Gripes About Health Costs Punctuate A Cross-Country Trip

Dudley Pratt (left) talks to reporter Jenny Gold at a gas station in Fenner, Calif. He's frustrated by all the paperwork related to his health insurance these days.

Ilana Lipsett
/ Jenny Gold

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Originally published on June 9, 2014 2:26 pm

Recently, I moved from Washington, D.C., to San Francisco. I drove the Southern route and decided to conduct an informal survey.

I asked folks I met along the way a question relevant to the health care reporting I've been doing for the past five years: What bugs you most about your medical care?

Few people I talked with — at gas stations, coffee shops, grocery stores, parking lots, bars and everywhere in between — even mentioned the Affordable Care Act or Obamacare by name. But I heard again and again how health policy issues I've been reporting on in Washington are affecting their lives.

What did I find out?

From coast to coast, people told me that their health coverage and care are too expensive. "I wish it would be cheaper mainly — more affordable," Ruben Irigoyen of Springerville, Ariz., told me. "That's mainly my concern. Everything is just very expensive, especially in these small communities."

A few people were able to buy more affordable insurance on the new marketplaces created by the health law. "I'm not really happy with how much things cost. But I did get a plan through HealthCare.gov and that helped a lot," said Christa Sadler of Flagstaff, Ariz.

But the United States continues to spend more on health care than any other country in the world. And Angie Wilson of Nashville, Tenn., had experienced that firsthand. "Of course the cost" is the big problem, she told me. "The cost! It's expensive. That's the main thing."

Hospitals across the country are seeking to improve medical care by getting primary care doctors, specialists, nurses and everyone in between to work together to coordinate the care of their patients. Under the health law, the government is penalizing hospitals if too many of their patients return quickly after being discharged. Those readmissions are an expensive symptom of uncoordinated care.

But care coordination is still a work in progress. "I am very upset because my wife had major surgery last Thursday, and they made her leave the hospital on Friday at 7 o'clock at night, and now she's back in the hospital because she shouldn't have left so early," said Glenn Ferreri in Brandon, Miss. "So I'm unhappy about the health care regulations going on that's pushing people out so that we have to take care of them at home where the care should be at the hospitals."

Right now, there's a big push to get computers and electronic health records in hospitals and doctors' offices across the country. Karen Greig of Menlo Park, Calif., says there are drawbacks for patients.

"The way the computer in the examining room has come between me and the doctor. Half the time they don't even look you in the eye because they're busy typing away, looking at the computer and you're wondering are they even hearing what I'm saying?" Greig told me in a Flagstaff, Ariz., coffee shop.

People I talked with were worried about who would take care of them. Will there be enough primary care doctors to meet demand from patients, especially as more Americans get insurance coverage under the health law. Hart Fortenbery in Lafayette, La., was particularly concerned about having to see a nurse practitioner instead of a doctor as more mid-level providers are taking on a bigger role in primary care.

"What bugs me most about my medical care is the state of the doctors," he said. "You can't see a doctor, and if you do they got to see 50 goddamn people a day. They're stressed, overworked, underpaid, and you end up with a nurse practitioner who's able to write prescriptions."

At a gas station in Fenner, Calif., just miles from the Arizona border, I met Dudley Pratt of Huntington Beach, Calif. He was riding his dirt bike across the Mojave Preserve.

He's said he's a free spirit, and it's all the paperwork about health insurance that drives him nuts. "I can remember back in the '70s, you would have, like, Blue Cross Blue Shield, you go in and you hand them a card. There was no paperwork or copays," he said. "You just went to the ER or whatever. Now it seems a lot more complicated."

And then were even a few people who – lo and behold – were actually happy with their medical care. I met Don Chalmers of San Diego, Calif., at the same gas station in Fenner. "I will tell you I have always had good luck with my medical care," he said. "Every time I went to the hospital I came out better than when I went in."

This is WEEKEND EDITION from NPR News. I'm Rachel Martin. With all the political wrangling we've heard over the Affordable Care Act, it can be easy to forget just how personal the issue of healthcare is. Reporter Jenny Gold has been covering a lot of this for Kaiser Health News and NPR. She recently moved from Washington, D.C., to San Francisco and took a cross-country road trip to do it. In her stops along the way, she took a little time to ask people about their views of health care. She joins me now from San Francisco. So, Jenny, this is a pretty long road trip. How did it go? How was it?

JENNY GOLD: It was really fantastic. I took about two weeks to do it, and I drove the southern route. And I decided, when I started out, that I'd ask people the same question - what bugs you most about your medical care?

MARTIN: Which is a question guaranteed to get a lot of varied, interesting responses, I'm sure. Very provocative. What did you hear from people?

GOLD: You know, it was surprising to me that not very many people brought up Obamacare. Most of them were really personal and specific, like a bad experience their mom had in the hospital or, you know, the time their doctor missed something important. But from coast-to-coast and everywhere in between, one answer did keep coming up. Let's hear from some of them.

CHRISTA SADLER: I'm not really happy with how much things cost.

ANGIE WILSON: Of course, the cost. The cost. It's expensive.

RUBEN IRIGOYEN: I wish that it will be cheaper - more affordable, especially in the small communities.

KRISTIE GALY: I guess that - the high price of some of my medications, even after insurance.

GOLD: That was Christa Sadler of Flagstaff, Arizona, Angie Wilson from Nashville, Tennessee, Ruben Irigoyen of Springville, Arizona, and Kristie Galy from Baton Rouge, Louisiana. And some of the people said those costs were sometimes so high, they skipped care recommended by their doctor. And then for other people, it was the care they received that bugged them the most, often in the hospital.

GLENN FERRERI: My name's Glenn Ferreri. I live in Brandon, Mississippi, right out of side of Jackson. It's a suburb. And I am very upset because my wife had major surgery last Thursday. And they made her leave the hospital on Friday at 7 o'clock at night. And now she's back in the hospital because she shouldn't have left so early.

GOLD: There were also plenty of complaints about doctors.

HART FORTENBERRY: My name is Hart Fortenberry, and I live in Lafayette, Louisiana. What bugs me most about medical care is the state of the doctors. You can't see a doctor. You know, and if you do, they got a see 50 goddamn people a day.

GOLD: And then was insurance. Maria Whitrock of Portland, Oregon, just changed her family's plan. And it was a problem for her husband, who'd been on the same medication for seven years to manage his Crohn's disease.

MARIA WHITROCK: When we switched insurance, they said you can't be on this medication. It's too expensive. And you can't go on it until you try four other medications.

GOLD: And then there was Dudley Pratt of Huntington Beach, California, who I met at a gas station along Route 66.

GOLD: He's a free spirit, and it's all the paperwork that drives him nuts.

PRATT: And I can remember back in the '70s, you would have, you know, like Blue Cross Blue Shield. You go in, and you hand them the card. There was no paperwork. There was no co-pays. Now, seems a lot more complicated.

MARTIN: So a lot of people with a lot of complaints. But understand you did find a couple of folks who are actually pretty happy with their health care, right?

GOLD: Yeah, they were few and far between. But 58-year-old Don Chalmers of San Diego, who was on that dirt bike ride, gave it a thumbs-up.

DON CHALMERS: I'll tell you that I have always had good luck with my medical care. Every time I went to the hospital, I came out better than when I went in.

MARTIN: Which is definitely not a sentiment you hear a lot. But, Jenny, thank you so much for bringing these voices from your road trip. We appreciate it. And enjoy San Francisco.